Negative affect predicts social functioning across schizophrenia and bipolar disorder: Findings from an integrated data analysis

Abstract

Most people with a serious mental illness experience significant functional impairment despite ongoing pharmacological treatment. Thus, in order to improve outcomes, a better understanding of functional predictors is needed. This study examined negative affect, a construct comprised of negative emotional experience, as a predictor of social functioning across serious mental illnesses. One hundred twenty-seven participants with schizophrenia, 113 with schizoaffective disorder, 22 with psychotic disorder not otherwise specified, 58 with bipolar disorder, and 84 healthy controls (N=404) completed self-report negative affect measures. Elevated levels of negative affect were observed in clinical participants compared with healthy controls. For both clinical and healthy control participants, negative affect measures were significantly correlated with social functioning, and consistently explained significant amounts of variance in functioning. For clinical participants, this relationship persisted even after accounting for cognition and positive/negative symptoms. The findings suggest that negative affect is a strong predictor of outcome across these populations and treatment of serious mental illnesses should target elevated negative affect in addition to cognition and positive/negative symptoms.

The Fragile Brain: Stress Vulnerability, Negative Affect and GABAergic Neurocircuits in Psychosis

“…Many of the studies we cite include schizoaffective patients, but there has been little attempt to differentiate NA in schizoaffective disorder and schizophrenia, aside of the obvious higher incidence of NA (depressive symptoms) in schizoaffective disorder. 64 Although we see the proposed GABAergic mechanisms of vulnerability and NA as transdiagnostic, most of the relevant research has occurred in schizophrenia; hence, our focus.…”

“…[65][66][67] Depression occurs in 30%-50% of schizophrenia patients, 68,69 and social phobia in 13%-36% of schizophrenia cases, [70][71][72] with as many as 60% of patients experiencing some form of social anxiety. 73 NA is associated with poor social functioning and poor quality of life, after controlling for positive and negative symptoms, 32,64,74,75 suggesting that it is an important target for interventions.…”

“…An inverse relationship between neurocognition and stress sensitivity was reported in one study, 77 whereas another group found that poor memory performance was directly related to more NA. 78 Studies have generally found that NA is an independent predictor of poor functional outcome, after controlling for neurocogni tion, 64,75,79,80 but this does not preclude that cognition might interact with NA, as some have found. 79 Indeed, as we suggest, PVI dysfunction may be a "third variable" that could also cause the association between impaired cognition and NA.…”

Positive and negative affect as predictors of social functioning in Spanish children

“…The relation between affect and social functioning has been investigated, in particular using clinical samples. It has been found that in young adults and adults (18–68 years old) PA has been positively related to social functioning scores [ 22 – 24 ] whereas NA has been related negatively [ 25 – 27 ]. The very few studies examining this relationship in community samples have focused on young adults and adults (18–35 years old).…”

Altered hippocampal centrality and dynamic anatomical covariance of intracortical microstructure in first episode psychosis

“…It is also acknowledged that our patient sample is quite heterogeneous in terms of diagnosis, where we have included both affective and nonaffective psychosis. Negative symptoms can be challenging to study in affective psychosis populations; however, negative symptoms have been reliably observed in patients with affective psychosis (Grove et al, 2016;Guessoum, Le Strat, Dubertret, & Mallet, 2020;Sauvé, Brodeur, Shah, & Lepage, 2019;Strauss et al, 2018;Strauss, Vertinski, Vogel, Ringdahl, & Allen, 2016). We have also previously controlled for diagnosis in our brain imaging studies of negative symptoms, finding that results are not altered (Makowski et al, 2017;.…”